Healthcare Provider Details

I. General information

NPI: 1730824962
Provider Name (Legal Business Name): AARON ROTTIER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2022
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 ROSE ST # HQ101
LEXINGTON KY
40536-1622
US

IV. Provider business mailing address

800 ROSE ST # HQ101
LEXINGTON KY
40536-7001
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-2636
  • Fax:
Mailing address:
  • Phone: 859-323-2636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number60435
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: